Healthcare Provider Details

I. General information

NPI: 1174448278
Provider Name (Legal Business Name): KRISTIE CALDWELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

905 MILTON BLVD
NEWTON FALLS OH
44444-9707
US

IV. Provider business mailing address

7320 N PALMYRA RD
CANFIELD OH
44406-9709
US

V. Phone/Fax

Practice location:
  • Phone: 330-369-4033
  • Fax:
Mailing address:
  • Phone: 330-369-4033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number1200577
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: